Tokelau Culture

Contributors

• Drew Clark
• Kaelyn Solomon
• Stephanie Johnson

Editors/Reviewers

• Sean N. Bennett, RN, MSN - Associate Professor - Utah Valley University

Tokelau, a territory of New Zealand, is a small collection of islands located in the South Pacific. It is approximately 500 kilometers North of Samoa. Tokelau consists of three small coral atolls: Atafu, Nukunonu, and Fakaofo. With a combined land area of about five square miles, approximately 1,500 people reside in Tokelau. Residents speak Tokelauan and English. Although New Zealand has ownership over Tokelau, Tokelau manages their own laws and government (Government of Tokelau, 2014).

In the 1860�s, Peruvian ships arrived on the island of Tokelau. All able-bodied men were taken into captivity and forced into slavery. Unfortunately, many of the men died while in captivity. This compromised the well-being of the Tokelau people, leaving the women and children to learn to survive for themselves. Many years later, people from other islands, including Samoa, began to repopulate the area. (Government of Tokelau, 2014). Those who came and settled in Tokelau, have established the culture of the island today.

Each island is known for having their own village, which is run by an Elder. Each Elder is a chosen, respected family member of their village (Government of Tokelau, 2014). The elder helps run their village in the most beneficial way for their people. In these villages, women are expected to run the home and family, while the men are expected to run the harvest and fishing (Government of Tokelau, 2014). The villages come together to work as a team and provide for everyone. On these islands, land is known to be shared by everyone and owned by everyone (Government of Tokelau, 2014). Everything that is produced on the land is available to all that live there (Government of Tokelau, 2014).

Since Tokelau is such a small and remote island, they receive very few visitors. There are no vehicles, airports, or ship harbors on the island. The locals use canoes as their main source of transportation in order to fish, and to ship products to other islands. Fish is the main food supply on the island, so canoes play a vital role in supporting the Tokelau people. In fact, because the canoes play such a significant role, each of the Elders have assigned certain men to be �master canoers." These men specialize in building and repairing canoes for the whole island (Government of Tokelau, 2014).

The people of Tokelau have learned to adapt to their surroundings, utilize their strengths, and ultimately develop the necessary survival skills to live on a small and remote island. Tokelau is a small, but mighty culture whose hearts are knit together in unity for each other, and for God.

"Faka Tokelau" is a popular Tokelau phrase that means the �Tokelauan Way� (Culture, n.d.). This phrase represents the strong values the islanders hold. At the focal point of these values is a fierce commitment to family and community. Among the community, traditional gender roles are of the utmost importance to the Tokelauans. Women are responsible for taking care of the home, raising the children, and processing the food gathered by the men. Men are responsible for fishing and harvesting. Together the Tokelauan people work to unify their families and community (Culture, n.d.).

As part of their commitment to community, the Tokelau people value providing for and taking care of each other. A good example of this sense of community can be seen in what the Tokelauans call the inati system (Communal Fishing, 2004). As mentioned previously in this text, fishing is an important part of the Tokelau culture, traditions, and economy. The inati system is a fishing ritual that involves the distribution of fish to all households on all three atolls of the Tokelau islands. After the men return home from their fishing expedition, they sort the fish by size and species. The fish are then distributed to families according to family size and needs. No family goes unaccounted for. The men work together to share the responsibility of providing for and supporting the community. In essence, they treat one another as family. As fishing is such an important aspect of their culture and survival, the Tokelauans are keenly aware of the importance of respecting their environment, keeping it clean, and raising awareness on how to protect their islands (Communal Fishing, 2004).

While fishing is an important aspect of Tokelau tradition and values, music and dance are also very significant. The Tokelauans express their beliefs and tell their stories through both of these art forms (Guampedia, 2022). Music and dance play a major role in exemplifying Tokelau values and keeping their traditions alive throughout generations.

The phrase �Maopoopo� is a significant phrase in Tokelau culture. It is a guiding principle which means, �a unity of a common purpose that encompasses both body and spirit� (Guampedia, 2022). This principle can be seen in the way the Tokelau people treat each other and how they strive for unification. Additional core values of the Tokelauans include respect, dignity, love, compassion, and spiritual beliefs. They emphasize the importance of serving and showing compassion towards even the most vulnerable residents of their islands (Guampedia, 2022).

Ultimately, the Tokelau values resemble many of the core values seen in other Polynesian cultures. The significance of family and community guides many of their decisions, beliefs, and traditions. Patriotism, respect for their elders, and a deep sense of unity is the true Tokelauan Way.

The Tokelauans value the significance of traditions. One of the most important traditions is canoe carving. Despite new advancements in boats, canoes are still chosen as their main source of watercraft for fishing (Fishing and canoes, n.d.). In addition to safety, versatility, and maneuvering benefits, canoes are the top choice for fishing in Tokelau to maintain the tradition of canoe building throughout generations. Unfortunately, due to a lack of wood from the Kanava tree on the other islands, Atafu is the only Tokelauan island to maintain canoe building in the present day. Additional knowledge about fishing is passed down through generations such as fish migration patterns and the making of nets, traps, and lures. The lunar calendar is also utilized in the Tokelauans fishing expeditions.

The biennial Easter celebration is another major tradition in Tokelau (Walrond, 2015). This event is well attended and began when the Porirua Rugby Football Club hosted five teams from Tokelau in 1979. This tradition has since adapted to include netball, dancing, career opportunities, and health information. Most importantly, the Easter festival provides a unique opportunity for young Tokelauans to learn about their rich heritage (Tokelau Festival, 2017). Additional traditional holidays celebrated in Tokelau include Waitangi Day, and Tokehega Day (Culture, n.d.).

The arts play a major role in Tokelau culture. Mat making and wood carving are some of the unique skills they have developed (Walrond, 2015). Sports are highly cultural in Tokelau and often tie back to some of their roots, such as Western Samoa (Culture, n.d.). Popular sports in Tokelau include cricket and football. Gardening is also considered a recreational activity. However, it is mainly done out of necessity for food. Youth in the Tokelau community participate in sports and learn different art forms (Laban, 2008). They tend to be successful in these different activities due to their exposure from a young age. The youth exemplify great potential and energetic attitudes that contribute to their success.

Tokelauans believe in community and much of their way of life surrounds this belief. Many of the activities entertained in their communities are communal in nature (Ho�m, 1993). An attitude of cooperation and sharing is highly praised. Despite this belief, Tokelauans tend to keep knowledge privy to their own family unit. Knowledge is deeply associated with age and gaining knowledge is considered a lifelong journey in Tokelau. It is likely that one will not be considered wise until they have reached the age of 70. The amount of knowledge that one is perceived to have often ties with their personal knowledge about genealogy, navigation, star positioning, traditional sounds, and the land.

Throughout the Tokelau islands, Christianity is considered to be the predominant religious belief. Prior to the nineteenth century, and the introduction of Christianity, Tokelauans prayed to the god, "Fakaofo," He was seen as the high spirit, who brought blessings of abundance and fertility. Unfortunately, there is no record of what religious beliefs were practiced before Fakaofo. During the 1850's, Catholic and Protestant missionaries traveled to Tokelau to teach the people their beliefs. Their goal and desire was to convert the islanders in order to save their souls. Many islanders on Atafu accepted the Catholic teachings, but those on Nukunonu chose to follow Protestantism. After the nineteenth century, many people immigrated to Tokelau and brought with them their own Christian beliefs. Today, Christianity continues to stand as the predominant religion on the islands.

Values and beliefs such as respecting your Elders, obeying your parents, treating others with equality, and focusing on unity within the community, are important aspects of Christianity that the Tokelau people emphasize. Throughout the islands, church services are held on Sundays. This is a time to worship God. Tokelauans pray to God, perform baptisms, and participate in religious weddings. Their strong belief in community is often intertwined with their religious beliefs. Gatherings are often held to build friendship and to provide service opportunities. Additionally, these gatherings consist of dancing, singing, cricket matches, games, entertainment, and enjoying good food.

The Pastor is the leader of the Church on the islands. He may invite other members of the congregation to help serve the Church along with deacons and preachers. Each of these leadership positions are held by male members of the community. As it pertains to Christian beliefs, they accept the Bible to be the word of God. They use the Bible to preach and to provide teachings about the Godhead and other Christian beliefs. The Godhead consists of God, who is the creator of the heavens and the earth, Jesus Christ, who is seen as the son of God, and lastly, the Holy Spirit.

Beliefs surrounding death are very unique to the Tokelau people. When a community member passes away, a bell is rung at one of the churches until the community member's burial has been performed. This is seen as an important ceremony where religious hymns are sung and prayers are offered. After death, the Tokelauans believe that following the burial, the individual who has passed will either bring an abundance of fish to the community, or they may bring misfortune to the community, or to their family.

Social harmony and inner peace are important aspects of the Tokelauan's sense of self. They strive for unity and peace within their communities and family, which comes from striving to be service-oriented. Knowledge is another important aspect of one's sense of self. In Tokelauan, "katoa" means wholeness, fullness, or richness of detail (Ho�m, 1993). This concept is related to the importance of individuals striving to become whole, which includes gaining knowledge. As children and adolescents, the Tokelauans perceive young people as incomplete human beings. Through experience and maturity, strength is gradually acquired. However, one does not attain knowledge and judgment until one grows older. Due to age and life experience, older adults have acquired the knowledge necessary to be vested with the power to judge. This is part of the reason for why elders are so respected in the Tokelau community. Elders have the power to regulate activities within the villages and council on behalf of the well-being of their people and impose specific rules and regulations. Gaining wisdom, knowledge, power, and experience is an ongoing refining process that contributes to the significance of Tokelauan's sense of self (Ho�m, 1993).

Christianity plays a vital role in the beliefs of many Tokelauans today. However, similar to Polynesian culture, beliefs surrounding deities, gods, souls, connection with earth and sea, and animism are essential aspects of the Tokelau people's sense of self and space (Walker, 2022). Many ancient traditional beliefs are still important to Tokelau culture today (The World Factbook, 2023). Tokelauans survive off of their surroundings. Therefore, they are passionate about preserving their environment to ensure Tokelau's future is secure. Land and space are shared amongst the Tokelau people. They work together to provide for one another and care for each other.

The people in Tokelau understand the devastating effects climate change and weather have on their country. As such, they have begun to build cement walls surrounding their islands to protect their community, homes, and families from harsh storms coming their way (Sohkin & Webb, 2016). The Tokelau islands are especially at an increased risk for cyclones, which have increased in intensity and frequency as the climate changes (Tokelau, 2019). In 2012, Tokelau transitioned to a 100 percent solar-powered country. Their efforts to use natural resources to sustain life contribute to their effort to preserve their country. In 2021, the Tokelau community chose this phrase for their Tokelau Language Week, �Tokelau! Tapui tau gagana ma tau aganuku, i te manaola ma te lautupuola� which means �Tokelau! Preserve your language and culture, to enhance spiritual and physical wellbeing" (Sio, 2021). Their belief in cultural preservation fuels their efforts to protect their surroundings.

Gagana Tokelau is the primary language spoken in Tokelau (Te vaiaho, 2021). Approximately 88.1 percent of the population speaks Gagana Tokelau (Central Intelligence Agency, 2023). English is the second most popular language. About 48.6% of Tokelauans speak English. Other common languages spoken in Tokelau include Samoan, Tuvaluan, and Kiribati. Gagana Tokelau is a Polynesian language that is spoken in New Zealand, Samoa, Hawaii, Australia, and American Samoa (Te vaiaho, 2021). Gagana Tokelau has close ties with the Samoan language. Additionally, Tuvalu and Kiribati have influenced this language. The influence of these languages originated from printed materials but have been strengthened as recent generations have had heightened amounts of contact with these cultures. Although Gagana Tokelau is the primary language in Tokelau, it is recognized by UNESCO to be a severely endangered language, despite the fact that it has gained traction in other countries besides New Zealand (Plan for the future, 2022).

Beyond the logistics of the language, Gagana Tokelau allows Tokelauans to connect meaningfully with their community (Learning Languages Gagana, 2023). Gagana Tokelau also strengthens intergenerational relationships among those living in Tokelau. Individuals who are in the process of learning the language are encouraged to use their knowledge of the culture and history to enrich their understanding of the language. The beauty of Gagana Tokelau is that, in addition to its purpose to accomplish verbal communication, it also holds deep emotional connection and meaning. This language holds special significance for its users. Furthermore, learning the language can open additional career opportunities by increasing employability, improving problem solving abilities, boosting creativity, and demonstrating an interest in more than your immediate surroundings. Unfortunately, despite the benefits, there are limited opportunities to learn Gagana Tokelau (Plan for the future, 2022).

There are six main ideas that exist in Gagana Tokelau (Learning Languages Gagana, 2023). The first idea is that learning the language not only keeps it alive, but it also contributes to the well-being of the overall community. The second main idea is that learning the language allows you to connect with your own culture and communicate transculturally. The third main idea is that unique meaning can be conveyed through each language. The fourth main idea is that language, culture, and identity have an inseparable link. The fifth main idea is that learning different languages increases diversity. The final idea is that learning languages teaches more than just communication; it teaches persistence, empowerment, and resilience.

The people of Tokelau utilize resources beyond their spoken language. Tokelauans have a telecommunication system on the islands that allows for phone and internet use (Central Intelligence Agency, 2023). Internet use is only utilized by 58 percent of the population, with an estimated total of 805 users in 2019. With these statistics, Tokelau ranks number 228 out of the 231 in worldwide internet usage. In addition to internet use, Tokelauans use a broadcasted radio service and sky TV to communicate weather and shipping reports.

In Tokelau, they are limited on their food resources. Being on an island, they rely on fish and food they can grow. In the past years, this was the only form of food for the whole island. The fishermen would go out, catch what they could for the day, return and share findings with the community. This event was known as �inati.� The marine life around the island is very important to the Tokelau diet and nutrition (Mallon, 2006).

Some popular fish that are caught are Kakhu, which means yellowfin tuna, Palu Malau, which means ruby snapper, Paala, also known as Wahoo, and Mahimahi, known as dolphinfish (Fish of Tokelau, 2012). Popular foods that are grown on the island are coconuts, bananas, taro, breadfruit, poultry, pandanus and papayas. Plants like taro and breadfruit have to be grown in a specific location on the island. They were planted and grown in ponds dug down into freshwater found beneath the sand (Mallon, 2013).

Fresh water used to be difficult to come by on the island. The locals would dig large wells into the sand in order to find fresh water beneath it. Once they found a location with fresh water, they would then dig giant reservoirs that the whole community could access. Before the Tokelau people discovered fresh water beneath the sand, their only resource for fresh water was the rain.

Today, there are various foods imported to the island. These imports often come from the closest nearby islands. Some foods that are now imported are rice, flour, sugar, chicken, eggs, beef, vegetables, milk and cheese (Drewnowski, 2015). Importation has allowed for the Tokelaus to live a much healthier life and incorporate a more well-rounded diet. Prior to the importation of food, the Tokelau diet consisted of foods high in saturated fats, and low in cholesterol and carbohydrates. This diet increased the risk for health complications such as obesity, diabetes, high blood pressure, and harmful blood lipid levels (Harding, 2010).

The women are tasked with most of the cooking within their families. Recipes are passed down from generation to generation. Most of their cooking is done in an �umu,� which is known as an earth oven. They also cook on stoves called kerosene (Kelemete, 2006). Tokelau women use fermented coconut sap known as "Kaleva '' to bake. It is also enjoyed as an alcoholic beverage. Food is an important aspect of Tokelau culture. It truly has the power to bring the community together. During holidays and celebrations, the Tokelau people cook large amounts of food, and they prepare �rich and complex family dinners'' for the whole community (Tokelauan Cuisine, 2021).

Tokelauns use Tokelau Time all year round. As such, daylight savings time is not observed. Tokelau time is currently thirteen hours ahead of Coordinated Universal Time. While there are small differences, Tokelau time is very similar to New Zealand time. Clocks in Tokelau are either set at the same time as New Zealand clocks, or they are one hour ahead because they do not participate in daylight savings time (Current and Local Time in Tokelau, 2023).

Time in Tokelau is spent enjoying life and ensuring survival. As the three different atolls are continuously faced with ocean threats and challenges from climate change, the need to protect their country is significant. Tall concrete walls have been built around Fakaofo in hopes of preventing destruction from rising water levels and dangerous storm waves (Osipova & Sohkin, 2018).

Fishing provides the main source of food for the islanders. Time is often spent fishing and sharing what has been caught with the community. While some harvesting is done, the surrounding environment makes the soil difficult to work with.

Religion is an important aspect of the Tokelau culture and many of the people spend their days going to church. Easter is a special time of the year where most of the community comes together for their Easter ceremony (Osipova & Sohkin, 2018). This can be a very busy time of the year as much of their time is spent preparing for this ceremony. Additionally, due to religious purposes, Sunday is a day of rest. No work is allowed on this day. Evening silence is also enforced throughout the week for religious purposes (Osipova & Sohkin, 2018).

Curfews are observed in Tokelau and they follow a strict schedule. Working is reserved for during the day and the Tokelauans are required to stop working at 18:00 (Osipova & Sohkin, 2018). From 18:00 to 18:50, the residents are to be quiet and to rest from the day�s work. Games are not to be played during this time. From 18:50 to 19:00 this time is set for staying indoors and praying. From 19:00 to 21:00 residents are allowed to swim, play sports, finish chores, etc. This can be both a fun and busy time on the island. For children, the day ends at 21:00. At this time children are to return to their homes and to go to sleep. After 23:00, all remaining residents should return home. Additionally, residents are to be quiet after this time. Curfews are enforced by the police department of Tokelau as they patrol the islands at night (Osipova & Sohkin, 2018).

Sports are very popular in Tokelau and many residents spend their time enjoying various activities. Volleyball, rugby, and cricket are considered the most popular sports (Osipova & Sohkin, 2018). Furthermore, on the island of Fakaofo, time is spent socializing in the cool lagoon, enjoying raw fish with coconuts, and smoking cigarettes.

Tokelau has become increasingly independent from New Zealand since 1994 (Anderson et al., 2017). A couple of referendums to obtain self-government have occurred. Unfortunately, Tokelau did not reach the necessary percentage of votes required to make Tokelau its own governing body. Currently, the administrator for Tokelau is responsible for governing the nation. This administrator is an appointed New Zealand government official. The Minister of Foreign Affairs is the one who appoints this leader. The administrator delegates executive powers to those in leadership positions in the Tokelau villages. Those in leadership roles are known as Elders. The Elders of the village further delegate these executive powers to the General Fono.

The General Fono is currently made up of 20 members, each of whom serves a three-year term. The exact number of members in the General Fono varies based on population because one member is chosen for every 100 inhabitants of Tokelau (Administration, n.d.). When the General Fono is not in session, the titular head of government is responsible (Anderson et al., 2017). The titular head of government is made up of three ministers that are elected from each atoll. The decision-making power is rotated between these three ministers. These three ministers work together to exercise political power in conjunction with the mayor from each atoll. Any decision made by the titular head must be reported back to the General Fono (Administration, n.d.).

The social organization of Tokelau is much like other western Polynesian civilizations (Macgregor, 1937). However, some differences exist. Aside from the influence of Western Polynesia, both internal and external influences impact the social organization of Tokelau. Today Tokelau is a patrilineal society; however, historically Tokelau was a matrilineal society (Macgregor, 1937). It is believed that a tradition may have contributed to this shift in family roles. This tradition occurred after the birth of a first-born child. The mother and her relatives would parade around the islands to display the women�s beauty. While this purpose suggests a celebration of motherhood, it is likely that this tradition led to focusing on the announcement of an heir, which, in turn pushed Tokelau toward a patrilineal pattern.

Each island in Tokelau has one school. On Fakaofo, there is the Tialeniu School, on Nukunonu there is the Matiti School, and on Atafu there is the Matuala School. Between all three of these schools, there are approximately 400 students. The student to teacher ratio is seventeen to one. Each school is first grade through grade thirteen (Philipp, 2020). Up until 2008, there was no Senior year or grade thirteen offered for these students. If they wanted to continue their education past eleventh grade, they had to study abroad. By 2009, they were able to add grade thirteen to the curriculum. This allowed for an increase in the number of students at each school (Government of Tokelau, 2013).

Tokelau has struggled for over fifty years to maintain a sustainable education for the children on the island. This was mostly due to their remote location. The island's location made it difficult to get educational supplies, maintain good telecommunication and reliable internet service, as well as finding enough qualified staff to teach and help run the schools (Government of Tokelau, 2013). In the past, the majority of teachers working in Tokelau schools lacked proper qualification as well as their own personal education. Fortunately, the Village Councils, or the Taupalegas, stepped in to help improve the school systems. Taupalegas provided training for teachers and additional education. Teachers were given the opportunity to attend the University of the South Pacific undergraduate program. With this new opportunity, the Tokelau government has a goal to help 80 percent of their teachers attain the proper education and qualifications to be teachers on the island. The government has also worked with the Volunteer Service Abroad Program to help counteract some of the challenges found within the school systems. The Volunteer Service Abroad Program was able to send over twenty-six New Zealand teachers to help train the staff in Tokelau on specific school subjects (Philipp, 2020).

The official language studied on the island is Tokelauan (quote). By third grade, the students are required to learn the secondary language of English. By the time students are in sixth grade, 50 percent of lessons are completed in English, and this continues until eleventh grade. By the time these students are fifteen years old, they are fluent in English, with proficient English reading skills. In 2011, it was more common for male students to complete their schooling. However, since 2016 only two percent more of male students completed school over the females� students. Part of this is attributed to women becoming more active in the communities where they reside and the committees that help fund the islands (Philipp, 2020).

Tokelauans are considered to be exceptionally hard-working. Not only do they work to provide for their families and communities, but they work to sustain and support their country. As the three different atolls are faced with the challenges of natural disasters and rising water levels, the people are working hard to build structures to preserve the land and their people (Osipova & Sohkin, 2018). Additionally, infrastructure strategies are being implemented on all three atolls to combat these potential weather disasters and harsh climate changes.

Unemployment is nearly non-existent in Tokelau (UNDP, 2012). The national budget helps fund over 200 jobs, which are dispersed by the government. These jobs are a major source of income for most Tokelauans. Although there are many job opportunities, these are not necessarily long-term, or consistent jobs. Approximately half of all the jobs on the islands are considered temporary. It is also not uncommon for Tokelauans to frequently rotate between jobs (UNDP, 2012).

While it is a common practice in Tokelau for men to work and for women to stay at home, this is slowly starting to change (UNDP, 2012). Jobs surrounding fishing and agriculture are the most common occupations for men on the island. Technician jobs are also common for men. Many women are also involved in agricultural work. Unfortunately, agricultural jobs can be difficult and small scale due to the rough land and little to no soil (WHO, 2013). However, as more women gain educational opportunities past high school, Tokelau is seeing more women take on professional and clerical roles in office work (UNDP, 2012).

In 2010, the Tokelau National Strategic Plan (TNSP) was presented. The TNSP highlights important values to the Tokelau people surrounding their vision for the future and the developmental goals they hope to implement (Foua, 2010). Tokelauans are continuously working to increase opportunities for their people, ensure preservation and sustainability of the islands, and provide success and a good quality of life for those who reside on the atolls.

Tokelauans work Monday through Saturday (Brams Institute, n.d.). As Christianity is a significant practice throughout Tokelau, Sunday is considered a day of rest where many religious practices are observed. On this day, work does not take place. Religious observations also take place daily and work is temporarily suspended during these times (Brams Institute, n.d.).

In Tokelau, the top 12 risk factors that drive death and disability are high blood sugar, obesity, hypertension, tobacco use, poor diet, high levels of low-density lipoproteins, dysfunction of the kidneys, malnutrition, risks associated with occupation, risky sex practices, alcohol use, and sedentary lifestyle (Tokelau, 2020). The top ten causes of disability and death combined in Tokelau are heart disease, diabetes mellitus, stroke, kidney disease, chronic obstructive pulmonary disease, lower back pain, infections of the lower respiratory tract, road injuries, congenital diseases, and lung cancer. In 2019, Tokelauans spent an average of $382.56 out-of-pocket on healthcare. The average life expectancy for Tokelauans in 2019 was 71.3 years for females and 73.3 years for males.

The main goals of the Department of Health in Tokelau to improve healthcare are to protect the environment and the health of the residents, develop Tokelau�s healthcare workforce, and develop a healthcare system that is both effective and efficient (Department of Health, n.d.). They feel that there are a couple things required to achieve success in these areas: community participation/engagement and the ability to acquire resources. Together, with the help of the community, they hope to promote health awareness, decrease morbidity and mortality of chronic disease, decrease food insecurity, improve the availability of primary care, and improve the safety of Tokelau�s environment.

Tokelau has a hospital on each of the three atolls (Mafile�o et al., 2019). Due to the unique needs of many of the islanders, the patients require qualified staff with specialty training. However, these hospitals cannot afford the adequate staffing necessary (Thelwell, 2020). Unfortunately, this prevents many of the islanders� needs from being met. Furthermore, basic technology is lacking throughout these hospitals, such as x-ray devices. This problem is attributed to the inability of the islands to acquire the appropriate resources needed to properly care for the residents on all three atolls. Additionally, the total budget allocated to healthcare in Tokelau is insufficient for their needs. Tokelau spends more on healthcare than all other island nations (Mafile�o et al., 2019).

As a Registered Nurse (RN), it would be important to recognize:

Despite their high levels of non-communicable diseases, Tokelau has made large strides of improvement in addressing this disparity (Mafile�o et al., 2019).

References

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